Validity of the emergency severity index in predicting patient outcomes in a major emergency department

1Road Traffic Injury Research Center and Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

2Tabriz Health Services Management Research Center, Department of Health Services Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

3Department of Emergency Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

4Road Traffic Injury Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran

5Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran

Journal of Nursing and Midwifery Sciences:Vol. 3, issue 1; 1-7

Published online:Mar 14, 2016

Article type:Research Article

Received:Dec 04, 2015

Accepted:Feb 01, 2016

How to Cite:Faramarz PourasgharJafar Sadegh TabriziAlireza AlaMohammad Asghari JafarabadiHasan Abolghasem Gorji Validity of the emergency severity index in predicting patient outcomes in a major emergency department.J Nurs Midwifery Sci.3(1):e141262.https://doi.org/10.18869/acadpub.jnms.3.1.1.

Abstract

Background and Purpose: The emergency severity index (ESI) triage system has been recommended by the Ministry of Health
to classify patients at emergency departments. This study aimed to assess the validity of ESI system (version 4) in the emergency
department of a teaching hospital. Outcome measures were hospitalization, emergency department (ED) length of stay, resource
consumption, in-hospital mortality, and patient service costs.
Methods: In this retrospective cross-sectional study, medical records of 562 ED patients were reviewed to determine the ESI level and
outcome measures in April 2013. Possible correlations were assessed using Phi and Cramer's V and Spearman's Rho. Data analysis was
performed in SPSS V.16, and P value of 0.05 was considered significant.
Results: In this study, frequency of five ESI levels (1-5) was 24, 14, 365, 158 and 0, respectively. In addition, Phi and Cramer’s V for
hospitalization and mortality were 0.350 (P<0.001) and 0.345 (P<0.001), respectively. Spearman's Rho for patient service costs, ED
length of stay, and resource consumption were -0.434 (P<0.001), -0.015 (P=0.362), and -0.411 (P<0.001), respectively. According
to our findings, the association between triage levels and resource consumption was more significant compared to other outcome
measures.
Conclusion: According to the results of this study, ESI triage ratings could successfully predict patient outcomes in terms of
hospitalization, in-hospital mortality, resource consumption, and patient service costs. Therefore, use of this valid triage system is
recommended for the arrangement of human and physical resources at emergency departments.

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Author(s):

Faramarz Pourasghar:[PubMed][Scholar]
Jafar Sadegh Tabrizi:[PubMed][Scholar]
Alireza Ala:[PubMed][Scholar]
Mohammad Asghari Jafarabadi:[PubMed][Scholar]
Hasan Abolghasem Gorji :[PubMed][Scholar]